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Montana rates for HCPCS L1100

Addition to cervical-thoracic-lumbar-sacral orthosis (CTLSO) or scoliosis orthosis, ring flange, plastic or leather

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.13 / $689.21 / $689.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$111.95 / $188.12 / $188.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.95 / $152.97 / $188.12
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.88 / $179.16 / $188.12
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.95 / $141.19 / $193.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.78 / $89.38 / $102.32